Application of low-dose CT combined with model-based iterative reconstruction algorithm in oncologic patients during follow-up: dose reduction and image quality

Objectives: To compare image quality and radiation dose of CT images reconstructed with model-based iterative reconstruction (MBIR) and hybrid-iterative (HIR) algorithm in oncologic patients. Methods: 125 oncologic patients underwent both contrast-enhanced low- (100 kV), and standard (120 kV) dose CT, were enrolled. Image quality was assessed by using a 4-point Likert scale. CT attenuation values, expressed in Hounsfield unit (HU), were recorded within a regions of interest (ROI) of liver, spleen, paraspinal muscle, aortic lumen, and subcutaneous fat tissue. Image noise, expressed as standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. Radiation dose were analyzed. Paired Student’s t-test was used to compare all continuous variables. Results: The overall median score assessed as image quality for CT images with the MBIR algorithm was significantly higher in comparison with HIR [4 (range 3–4) vs 3 (3-4), p = 0.017]. CT attenuation values and SD were significantly higher and lower, respectively, in all anatomic districts in images reconstructed with MBIR in comparison with HIR ones (all p < 0.001). SNR and CNR values were higher in CT images reconstructed with MBIR, reaching a significant difference in all districts (all p < 0.001). Radiation dose were significantly lower in the MBIR group compared with the HIR group (p < 0.001). Conclusions: MBIR combined with low-kV setting allows an important dose reduction in whole-body CT imaging, reaching a better image quality both qualitatively and quantitatively. Advances in knowledge: MBIR with low-dose approach allows a reduction of dose exposure, maintaining high image quality, especially in patients which deserve a longlasting follow-up.